APK4120 Exam 2

1. coronary heart disease (CHD)

2. heart failure

3. hypertension

4. stroke

What are the 4 things that comprise cardiovascular disease (CVD)?

cardiovascular disease (CVD)

What is the leading cause of death in the US?

coronary heart disease (CHD)

Approximately 50% of all CVD deaths are from _____

65

What is the average age of first MI for men?

72

What is the average age of first MI for women?

sex difference (estrogen prevents heart attacks, and when a woman hits menopause her estrogen levels decrease)

Why do, on average, women experience MIs later in life?

coronary artery disease (CAD)

What is another term for cardiovascular disease (CVD)?

acute coronary syndromes (ACS)

What is coronary heart disease (CHD) comprised of?

1. unstable angina pectoris (chest pain)

2. acute myocardial infarction (heart attack)

3. potentially sudden cardiac death

What are the 3 things acute coronary syndromes (ACS) include?

unstable angina pectoris

What is the result is ischemia?

ischemia

decreased blood flow/oxygen to the heart causing angina

angina pectoris

chest pain

unstable angina pectoris

a condition where chest pain occurs randomly and is often more severe, indicating a higher risk of heart attack

myocardial infarction (MI)

heart attack

acute myocardial infarction (MI)

death of cardiac muscle cells due to prolonged ischemia

60

An acute MI is an occlusion for ___+ minutes

acute myocardial infarction (AMI)

_____ is linked to unstable angina —> when ischemia is prolonged, heart tissue will die

potentially sudden cardiac death

abrupt loss of heart function caused by electrical disturbance

myocardial infarction (MI)

When a potentially sudden cardiac death occurs, the electrical disturbance may be triggered by ___

potentially sudden cardiac death

What is the least common ACS?

potentially sudden cardiac death

result of life threatening arrhythmias that causes the heart to stop and may or may not ultimately lead to death

endothelium

innermost layer of an artery; protects against atherothrombosis (plaque build up)

intima

thin layer of connective tissue on top of endothelium

intima

formation site of atherosclerotic lesions (where plaque initially occurs)

media

located on top of intima; contains mainly smooth muscle cells along with some connective tissue

media

What part of the artery is in charge of regulating the flw of blood with contraction and dilation?

adventitia

outermost layer of an artery; contains connective tissue, fibroblasts, and a few smooth muscle cells

lumen

space through which blood flows within an artery

intima

internal elastic layer; endothelium

media

external elastic layer; smooth muscle

atherogenesis

disease process that may result in blood flow—limiting lesions in the epicardial coronary, carotid, iliac, femoral arteries, and aorta

atherogenesis

underlying cause of cardio-degenerative diseases

athero-

plaque/vessel

-genesis

beginning/generation

endothelial injury

What is the first stage of atherogenesis?

endothelial injury

chronic or excessive plaque related injury

endothelial injury

result of longstanding issues that may repeat injury to the endothelium numerous times

• tobacco smoke and irritants

• LDL cholesterol

• hypertension

• glycated substances (hyperglycemia/diabetes)

• infectious agents (ie chlamydia, herpes)

Endothelial injury is caused by what?

inflammatory response

What is the second stage of atherogenesis?

1. endothelial injury

2. inflammatory response

3. endothelial dysfunction

4. plaque formation

What are the 4 stages of atherogenesis?

inflammation response

product of chronic/excessive injury

1. platelet aggregation

2. monocyte accumulation (WBCs)

3. foam cell/LDL-C accumulation

What are the 3 byproducts of the atherogenesis inflammatory response?

endothelial dysfunction

What is the third stage of atherogenesis?

endothelial dysfunction

product of chronic injury (after inflammatory response)

adhesiveness; artery wall

During endothelial dysfunction, there is an increased ______ of platelets and monocytes to the ______

lipoproteins

During endothelial dysfunction, there is increased permeability to _________ in the blood

vasodilation; vasospasm

During endothelial dysfunction, there is impaired ______ and increased ______

plaque formation

What is the fourth stage of atherogenesis?

platelets

During plaque formation, growth factors from _______ exacerbate growth and proliferation of plaque

intima; lumen

During plaque formation, lesions progress from ____ to other layers and leads to eventual narrowing of the _____

firm, pale gray plaque with a fibrous cap

Describe the plaque that occurs during plaque formation?

Plaque could break off and become an embolism causing a stroke (brain) or pulmonary embolism (lungs)

What is dangerous about plaque formation?

1. size and volume of lesions

2. stability of plaque

What 2 ways does progression of atherogenesis vary?

lifestyle factors

What contributes to new growth of plaque quickly?

plaque rupture; fissuring

The risk for embolus with atherogenesis is due to ______ or _________ of the fibrous cap

initial, smaller plaque

What type of plaque is more likely to break off/rupture?

stable

A complicated lesion or rupture is more _____ compared to foam cells

chest pain

What is the most common symptom of ACS?

1 in 4

Roughly ______ heart attacks have no regular symptoms

1. symptom hx (chest pain/angina)

2. silent MI

3. dyspnea (labored breathing)

4. atypical symptoms

What 4 things does the clinical assessment for ACS dx include?

silent MI

painless MI, ~25% of cases

flu symptoms, shoulder pain, fatigue

What are some atypical symptoms of ACS?